摘要目的 研究操作人员的操作经验对白酸蚀粘接剂与牙釉质及磷酸酸蚀后牙釉质粘接强度的影响.方法 对90颗牛切牙进行牙体预备,暴露牙釉质粘接面,平均分给3组人员:无操作经验组(A组)、4年操作经验组(B组)和10年操作经验组(C组).每组又进一步分为非酸蚀亚组和预酸蚀亚组.非酸蚀亚组采用白酸蚀粘接剂和复合树脂进行牙釉质粘接,预酸蚀组预先使用磷酸酸蚀剂进行酸蚀处理,然后按照非酸蚀亚组的步骤粘接.测试粘接试样的抗剪切强度,即粘接强度,并进行单因素方差分析.结果 对于非酸蚀试样,A组[(16.32±5.99)MPa]与B组[(21.36± 4.07) MPa]粘接强度的差异有统计学意义(P =0.006),而A组与C组[(18.77±3.78) MPa]的差异无统计学意义(P=0.163)；对于预酸蚀试样,A组[(21.34±5.62)MPa]与B组[(26.18± 3.57) MPa](P=0.007)、A组与C组[(25.35 ±4.51) MPa] (P=0.023)粘接强度的差异均有统计学意义.无论是非酸蚀试样,还是预酸蚀试样,B组与C组粘接强度的差异均无统计学意义(P=0.140和0.672).具有操作经验人员操作后的粘接强度高于没有操作经验的学生.此外,3组操作人员的非酸蚀亚组与预酸蚀亚组之间的差异均有统计学意义(A组P=0.025、B组P=0.002、C组P=0.000).预酸蚀处理增加了白酸蚀粘接剂与牙釉质的粘接强度.结论 操作经验对粘接强度有显著影响.为了获得最佳的粘接效果,不仅需要具有粘接理论基础知识,同时还需要一定的操作经验,并应严格按照说明书要求操作.

abstractsObjective To determine whether operator's skills could influence shear bond strength (SBS) of self-etch adhesive to enamel with or without prior acid-etching.Methods Total 90 bovine incisors were prepared to expose the enamel and randomly assigned to three groups according to the operator's experience:no experienced student group (Group A),four-year experienced expert group (Group B) and ten-year experienced expert group (Group C).Each group was further divided in two subgroups.In one of the subgroups,a self-etching adhesive and composite were applied in accordance with the manufacturer's instructions,and in the other subgroup,prior acid-etching with etchant were applied first,then self-etching adhesive and composite were applied.Shear bond strength of these samples was measured and the results were analyzed with one-way ANOVA.Results Without prior acid-etching,there was statistically significant difference between Group A [(16.32 ± 5.99) MPa] and Group B [(21.36 ± 4.07) MPa] (P =0.006),but no statistically significant difference between Group A and Group C [(18.77 ± 3.78) MPa] (P =0.163) was found.As for the prior acid-etching group,there were statistically significant differences between operators with and without previous experience,i.e.A [(21.34 ± 5.62 MPa) and B[(26.18±3.57) MPa](P=0.007),A and C[(25.35±4.51) MPa](P=0.023).Whether the subgroup with prior acid-etching or not,thcrc was no statistically significant difference between expert groups (Group B and Group C).The shear bond strength of experienced expert groups was higher than that in no experienced student group.Furthermore,there was statistically significant difference between subgroups with and without prior acid-etching,i.e.A (P =0.025),B (P =0.002) and C (P =0.000).The shear bond strength with prior acid-etching was higher than those without prior acid-etching.Conclusions Operator's experience in enamel adhesive appears to play an important role in determining the outcome of shear bond strength.In order to achieve optimal adhesive outcomes,it is important for operators to not only be familiar with adhesives' knowledge,but also have some practical experience and should operate strictly according to the manufacturer's instructions.